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Clinical Note |

Unexplained Extensive Skull Base and Atlas Pneumatization Computed Tomographic Findings

Bruno Moreira, MD; Peter M. Som, MD
Arch Otolaryngol Head Neck Surg. 2010;136(7):731-733. doi:10.1001/archoto.2010.108.
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Pneumatization of the mastoid and petrous portions of the temporal bones begins late in fetal life, accelerates near and immediately after birth, and continues through infancy, early childhood, and, occasionally, early adult life. This pneumatization can vary greatly, and in cases of well-pneumatized temporal bones, accessory occipital air cells may occur and communicate with the mastoid air cells and middle ear. Other accessory sites of air cell pneumatization include the zygomatic process, squamosal region, and styloid process of the temporal bone.1 Pneumatization of the occipital bone, including the craniocervical junction, is rare and, to our knowledge, has previously been reported only 10 times.210 In 4 of those cases,2,7,8 there was a history of trauma.

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Figure 1.

Coronal (A) and axial (B) noncontrast computed tomographic scan shows extensive pneumatization of the central skull base and C1. The pneumatization encircles the foramen magnum.

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Figure 2.

Coronal (A) and axial (B and C) noncontrast computed tomographic scans 1 week later show fluid accumulation within C1 and some of the central skull base as well as thickened fluid levels within the sphenoid sinuses.

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